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General NPI Number Information
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NPI Number | 1790758985
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Entity Type | Individual
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Provider Name | JEFFERSON ROBERT THURLBY M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/09/2006
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Last Update Date | 04/17/2012
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Provider Practice Location Address
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Address Line | 3215 N NORTHHILLS BLVD
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City | FAYETTEVILLE
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State | AR
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Zip | 72703-4424
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Country | US
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Telephone | 479-463-1000
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Fax | 479-463-5573
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Provider Business Mailing Address
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Address Line | PO BOX 1867
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City | FAYETTEVILLE
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State | AR
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Zip | 72702-1867
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Country | US
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Telephone | 877-898-9892
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Fax | 918-392-2941
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 21664
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 0101242416
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | E7407
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License Number State | AR
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